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Expert Rev Gastroenterol Hepatol. 2017 Mar;11(3):249-258. doi: 10.1080/17474124.2017.1284586. Epub 2017 Feb 7.

Intraperitoneal chemotherapy and cytoreductive surgery for peritoneal metastases coupled with curative treatment of colorectal liver metastases: an updated systematic review.

Author information

1
a Internal Medicine Department, Gastroenterology and Hepatology Division, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
2
b Medical Oncology department , Maadi Military hospital , Cairo , Egypt.
3
c Department of Surgery, Swiss Cancer institute , Zurich , Switzerland.
4
d Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany.
5
e Department of Surgery , OncoCentrum Zurich, Gastrointestinal Tumor Center Zurich (GITZ) , Zurich , Switzerland.
6
f Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.

Abstract

We aimed to assess the efficacy and safety of delivering intraperitoneal chemotherapy and cytoreductive surgery for peritoneal metastases coupled with curative treatment of colorectal liver metastases. Areas covered: A comprehensive literature search using PubMed was conducted to screen for eligible records. Studies evaluating colorectal surgery and intraperitoneal chemotherapy combined with curative treatment of liver metastases were included. We excluded duplicate publications. Sixty-seven full-text papers were assessed and six papers were finally included. The overall survival in the included studies ranged from 6-49 months. Five-year survival ranged from 18%-28%, three-year survival ranged from 22%-42% and two-year survival ranged from 34%-78%. Survival was lower in patients with liver metastases and peritoneal carcinomatosis (PC) than those with PC alone in the majority of studies. Expert commentary: This review poses questions rather than presenting answers. The heterogeneity of survival data suggests the possible benefit of this aggressive treatment approach in selected patients. Standardization of the technique used for intraperitoneal chemotherapy instillation, agent used as well as the systemic chemotherapy and targeted therapy type and duration through prospective controlled trials is required to provide an evidence of a higher strength to support or prohibit this treatment strategy.

KEYWORDS:

HIPEC; colorectal cancer; combined modality; cytoreduction; hepatic resection; peritoneal carcinomatosis

PMID:
28099818
DOI:
10.1080/17474124.2017.1284586
[Indexed for MEDLINE]

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